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Objective: To investigate the shortterm efficiency of overflow fecal incontinence treated by biofeedback and electrical stimulating therapy. Methods: Twenty children with overflow fecal incontinence were given combined therapy, biofeedback and electricalstimulating therapy,for four weeks. Every therapy cost 20 to 30 minutes. The grading of clinical incontinence degree ,measurement of pressure of the anus and rectum, electromyogram of muscles of solum plevis were done before and after the therapy. Results: Followup was done for a mean of 4.5 years (range 3 to 5), the subjective scores, maximum contractive pressure of anus, last contractive time, rectal volume at sensory threshold, contraction amplitude of external anal sphincter and pudenda neural latency were significantly different from the ones before treatment (P
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Objective To study the outcome of lost gallstones in peritoneal cavity. Methods Gallstones and bile collected from 51 patients undergoing laparoscopic cholecystectomy were analysed and cultured.One to three gallstones from each patient were placed into the peritoneal cavity of a corresponding Wistar rat on sterile condition. Results 8 rats died of peritoneal infection, intestinal fistula and ileus within one month. Abdominal wall abscess occured to one rat. All survival rats were sacrificed three months later. Pathologic results showed that the nidus of abscess appeared in tissue around the stone. Conclusions Lost gallstone is harmful to body. We should avoid gallstone lost in peritoneal cavity.
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Objective To evaluate the feasibility and effect of the treatment of hematopathy by laparoscopy plus small incision splenectomy. Methods Dissection and separation of the ligaments of the spleen with laparoscopy first. And then made a small abdominal incision to ligate and divid the pedicle of spleen to finish splenectomy. Sixteen cases of idiopathic thrombocytopenic purpura(ITP) and 4 cases of heriditary spherocytosis(HS), who were treated by medication but no effect or recurrence, were treated by this procedure. Results All the patients recovered smoothly without infection of the wound ,without fluid collection in the spleen fossa,and without great intraoperative blood loss.The operating time was 1.5～2.5h(average 2.2h), intraoperative blood loss was 30～85ml(average 65ml).Hospital stay was 4～7d( average 6d). No recurrence was found during the follow-up for 0.5 to 2.5 years in this series. Conclusions Laparoscopy plus small incision splenectomy in the treatment of some hematopathy has many advantages,such as less trauma, safety, effective and quick recovery.
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ObjectiveTo evaluate the influence of laparoscopic operation on pH value, phagocytic function of neutrophil, immunoadhesion activity of RBC CR 1 (complement receptor typeⅠ) in abdominal cavity. Methods Determination of the pH value, phagocytic function of neutrophil, immunoadhesion of RBC CR 1 in abdominal exudatives during laparoscopic procedures was undertaken and results were compared with the relative indexes detected in peripheral vein blood. Results The average pH value was 7.41, the percentage of the phagocyte was 74.6%, phagocytic index 55.7, and immunoadhesion activity of RBC CR 1 was 58% in blood during laparoscopic operation. While the average pH value was 7.14, the percentage of the phagocyte 65.6%, phagocytic index 47.6,and immunoadhesion activity of RBC CR 1 50% in the abdominal exudatives. Conclusion Compared with the peripheral vein blood indexes, the intraabdominal pH value, phagocytic function of neutrophil and immunoadhesion activity of RBC CR 1 decreased significantly during laparoscopic operation. The intraabdominal inflammation may diffuse with the effect of CO 2 pneumoperitoneum when patients with serious inflammation receive laparoscopic operation.
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Objective To evaluate the safety and feasibility of laparoscopic cholecystectomy(LC) in patients with cirrhosis,and compare the value of model for end-stage liver disease (MELD) score and Child-Pugh classification in predicting prognosis.Methods We reviewed the records of 55 laparoscopic cholecystectomies in cirrhotic patients in our department in the recent 11 years.Indications included symptomatic gallbladder disease,cholecystitis,cystic polyps and cystic adenoma.MELD score and Child-Pugh class were preoperatively calculated and associated with postoperative results.Data regarding patients and surgical outcome were retrospectively analyzed.Results No perioperative death occurred.Total cholecystectomy was employed in 53 patients and subtotal cholecystectomy in 2 patients.Median operative time was(77?5.1)min.Median intraoperative blood loss was(51.0?3.33)mL.Median hospital stay was(5.0?1.3)days.Postoperative complications occurred in 9.09% of the patients,including hemorrhage,intra-abdominal collections and wound complications,which were all controlled conservatively.The incidence of postoperative complications in Child A patients was 7.27%,in Child B was 10.0%;in MELD score below 14 was 2.44%,and in MELD score above 14 was 28.57%.The difference between rates of postoperative complications in patients with preoperative MELD score above 14 and below 14 was significant(P0.05).Conclusions Laparoscopic cholecystectomy is a safe procedure for selected cirrhotic patients,and with controllable complications.MELD score appears to predict morbidity more accurately than Child-Pugh classification system.
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ObjectiveTo evaluate the feasibility of endoscopic thyroid adenoma excision. Methods Dogs were used to practice endoscopic thyroid surgery under anesthesia. On the basis of animal experiment, endoscopic technique was introduced into dissection of follicular nodule of the thyroid lobe. One male and 11 females, aging between 23～52, underwent endoscopic enucleation of thyroid tumors from March 2002 to October 2002. Results The procedure was successful in 11 cases with 1 case converted to open surgery. The average time of operation was 70*!min, and intraoperative blood loss was 5～20*!ml. The patients had minimal pain. The cosmetic result was excellent. The incisions were completely hidden even with open necked skirt. Conclusions The cosmetic result of endoscopic thyroidectomy is satisfactory.